What is pharmacy

practice
Prepared by
Dr. Dima Saeed

Pharmacy Practice
1214302/1201324

Dr. Dima Saeed

References
• Whalley, Ben J., et al. Foundation in pharmacy practice.
Pharmaceutical, 2008
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407425/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774311/.
• https://www.sciencedirect.com/science/article/pii/B9780128017142
000113

Dr. Dima Saeed

 Definition of Pharmacy

➢Pharmacy: Derived from the Greek word

Pharmakon means medicine or drug.

➢Pharmacy: Is the art and science of

preparing, dispensing and proper utilization
of medications and the provision of drug-
related information to the public.

Dr. Dima Saeed

 Scope of Pharmacy
✓ Interpretation of prescription orders
✓ Compounding.
✓ Labeling.
✓ Dispensing of drugs and devices.
✓ Drug product selection and drug utilization reviews.
✓ Patient monitoring and interventions.
✓ Provision of information of medications and devices.

Dr. Dima Saeed

 Pharmacy education can be broadly divided into four areas:

1) Pharmaceutics (sometimes labelled as pharmaceutical technology)

and pharmacokinetics
2) Pharmaceutical chemistry
3) Pharmacology
4) Pharmacy practice which includes Clinical pharmacy

Pharmacotherapy
Social and administrative sciences

Pharmaceutical care
The first three categories are closely aligned with the basic sciences; the fourth category is
inclusive of the human sciences. Dr. Dima Saeed
This fourth category (Pharmacy practice) has greater ambiguity, at least in
terms of definitions.

Pharmacy practice in general: “is a description of what pharmacists

normally do while acting in a professional context and it represents also
the essential components and basic requirements for performing every
job or action related to pharmacy, including where and how pharmacists
do it.”

Dr. Dima Saeed

 Pharmacy practice

❖ In the context of pharmaceutical sciences, there is no concise and

precise definition of the term pharmacy practice.
❖ Pharmacy Practice Foundation in Pharmacy Practice (your text
book definition “Foundation in Pharmacy Practice” ) is the discipline
within pharmacy that involves developing the professional roles of
the pharmacist.

Dr. Dima Saeed

 ▪ There has always been a gap between pharmacy
education and actual practice of pharmacists
worldwide
The importance of ▪ Pharmacy students should have a comprehensive
pharmacy practice curriculum on pharmaceutical sciences and practice
related courses.
as a field of specialty▪ Qualified pharmacy graduate should have the essential
knowledge, skills, competencies, and the positive
attitude required for practice
▪ Pharmacy Practice is vital, since it facilitates and
enables pharmacists to fully exploit their substantial
knowledge and expertise in areas such as
pharmacology, pharmaceutics, chemistry and
therapeutics within a clinical context

Dr. Dima Saeed

 • Healthcare systems
• The role of the pharmacist
Critical parts of the • Communication skills
discipline • Adherence, compliance and concordance
• Law and ethics
• Pharmaceutical care and disease management
• Clinical interventions
• Continuing professional development (CPD)
• Extemporaneous dispensing
• Health psychology and social pharmacy
• Drug misuse and its treatment
• Adverse drug reactions
Dr. Dima Saeed
 Role of pharmacist
▪ The traditional role of the pharmacist: a dispenser of medicines prescribed by doctors and other
health professionals
▪ The pharmacist’s role has developed rapidly in recent years to include many other roles beyond the
dispensing of drugs.
▪ As health professionals, pharmacists are concerned not just with the treatment of existing disease
states, but also with their prevention and the promotion of healthier lifestyles.
▪ What pharmacists can contribute to health care is determined by the nature of their training and the
legal authority within their country
▪ The culture and traditions in different countries can determine the place of pharmacists in society
and the reliance that health care consumers place on pharmacists.
▪ In many countries pharmacists are the most accessible health care professional and have great
opportunity to recommend and implement wellness and treatment strategies.

Dr. Dima Saeed

 • Assuring effective delivery of medications to
Role of Pharmacist patients
• Minimizing potential adverse effects from the
medications or drug interactions
• Assisting health care providers and patients to
become more knowledgeable about medications.
• Promoting medication adherence
• Assuring the quality of medicines
• Assuring access to medications under conditions of
inadequate financial resources

Dr. Dima Saeed

 ✓ Clinical pharmacy is an important discipline in the practice of
The trend of clinical pharmacy – it has a lot to offer and has played an important
role in transformation of the pharmacy profession over the
pharmacy and the past two decades.
Pharm D “tag” ✓ Clinical pharmacy has been part of the “re-professionalization”
agenda both within the hospital and community sectors.
✓ It is a health specialty, which describes the activities and
services of the clinical pharmacist to develop and promote the
rational and appropriate use of medicinal products and
devices.

Dr. Dima Saeed

 Clinical Pharmacy
• Clinical pharmacy comprises a set of functions that promote the safe, effective and economic use of
medicines for individual patients.
• Clinical pharmacy process requires the application of specific knowledge of pharmacology,
pharmacokinetics, pharmaceutics and therapeutics to patient care
• The term "clinical" does not necessarily imply an activity implemented in a hospital setting. It
describes that the type of activity is related to the health of the patient(s).
• Clinical pharmacy is more of a concept than a setting because clinical services could happen in
hospitals, community pharmacies, or even in a patient’s home
• There are many definitions of clinical pharmacy, and the term “clinical pharmacy” has been
understood differently across the globe. Some relate it to “patient care”, whereas others associate it
more with the “managing appropriate use of medicines”.

Dr. Dima Saeed

 Includes a number of different
An emphasis in the profession
services such as
of pharmacy from the
individualized
mid1960s to the present,
(pharmacokinetic) dosing
which moved the focus from
services, and drug
drug product to patient
utilization review, which are
oriented services including
primarily provided in the
consultations
institutional setting
Clinical Pharmacy

Clinical pharmacists work

directly with physicians, other
health professionals, and
patients to ensure that the
medications prescribed for
patients contribute to the best
possible health outcomes

Dr. Dima Saeed

 Activities of Clinical Pharmacists
The principal activities of a clinical pharmacist include:

• Consulting: Analysing therapies, advising health care practitioners on the correctness of drug therapy
and providing pharmaceutical care to patients both at hospital and at community level.
• Selection of drugs: Defining "drug formularies" or "limited lists of drugs" in collaboration with
hospital doctors, general practitioners and decision makers.
• Drug information: Seeking information and critically evaluating scientific literature; organising
information services for both the health care practitioners and the patients.
• Formulation and preparation: Formulation and preparation of medicinal products and devices
according to acceptable standards to meet specific patients' needs.
• Drug use studies and research: Drug use studies/ pharmacoepidemiology/ outcome research/
pharmacovigilance and vigilance in medicinal devices: collecting data on drug therapies, their costs
and patient outcome through structured and scientific methods.

Dr. Dima Saeed

 Activities of Clinical Pharmacists
• Pharmacokinetics/ therapeutic drug monitoring: Studying the kinetics of drugs and
optimising the dosage.
• Clinical Trials: Planning, evaluating and participating in clinical trials.
• Pharmacoeconomy: Using the results of clinical trials and outcome studies to determine
cost- effectiveness evaluations.
• Dispensation & Administration: Dispensing and administration of medicinal products and
devices: studying and developing systems for the dispensing and administration of medicinal
products and devices that can guarantee a higher security in administration, a reduction of
expenditure and a reduction in medication errors.
• Teaching & Training: Pre- and post-graduate teaching and activities to provide training and
education programmes for pharmacists and other health care practitioners.

Dr. Dima Saeed

 Level of Action of Clinical Pharmacists
Clinical pharmacy activities may influence the correct use of medicines at three different
levels: before, during and after the prescription is written.
1. Before the prescription
• Clinical trials: Clinical pharmacists are also actively involved in clinical trials at different
levels: participating in ethical committees; study monitoring; dispensation and preparation
of investigational drugs.
• Formularies
• Drug information

✓Clinical pharmacists have the potential to implement and influence drug-related policies,
i.e., making decisions on which drugs deserve to be marketed, which drugs should be
included in national and local formularies, which prescribing policies and treatment
guidelines should be implemented.

Dr. Dima Saeed

 Level of Action of Clinical Pharmacists
1. During the prescription
• Counselling activity
• Clinical pharmacists can influence the attitudes and priorities of
prescribers in their choice of correct treatments.
• The clinical pharmacist monitors, detects and prevents harmful drug
interaction, adverse reactions ad medication errors through evaluation
of prescriptions' profiles.
• The clinical pharmacist pays special attention to the dosage of drugs
which need therapeutic monitoring.
• Community pharmacists can also make prescription decisions directly,
when over the counter drugs are counselled.
Dr. Dima Saeed
 Level of Action of Clinical Pharmacists

3. After the prescription

• After the prescription is written, clinical pharmacists play a key role in
communicating and counselling patients.
• Pharmacists can improve patients' awareness of their treatments, monitor
treatment response, check and improve patients' compliance with their
medications.
• As members of a multidisciplinary team, clinical pharmacists also provide
integrated care from 'hospital to community' and vice versa, assuring a
continuity of information on risks and benefits of drug therapy.
• Outcome research
• Pharmacoeconomic studies

Dr. Dima Saeed

 • The discipline of pharmacy embraces the
How does clinical knowledge on synthesis, chemistry and
preparation of drugs
pharmacy differ
• clinical pharmacy is more oriented to the
from pharmacy? analysis of population needs with regards
to medicines, ways of administration,
patterns of use and drugs effects on the
patients.
• The focus of attention moves from the
drug to the single patient or population
receiving drugs.

Dr. Dima Saeed

 • In Western countries, clinical pharmacy is
established only when a stable medicine system
is in place in the hospitals and drug regulatory
authorities are mandated and efficient.
Clinical pharmacy • Most developing countries do not have this
luxury and are struggling with the issues of
quality, safety, efficacy and distribution of
medicines. In this context, clinical pharmacy is
promoted as an isolated concept of practice and
the underpinning philosophies are poorly
understood and little has changed in terms of
patient care.

Dr. Dima Saeed

The trend of clinical pharmacy
and the Pharm D “tag”
• Amid these discussions in the developed world, the
change has also greatly affected the pharmacy sector in
developing countries, where establishing “clinical
pharmacy” programs is considered a novel phenomenon.
Under this influence, pharmaceutical care is popular
jargon with the basic undergraduate pharmacy degrees
having been changed to Doctor of Pharmacy (Pharm D)
and the number of years of study simply extended in
expectation of that.

Dr. Dima Saeed

 Pharm D
• The United States was the first country that has moved to a 6-year PharmD degree as the
sole credential for the professional pharmacy programme and focuses mainly on clinical
pharmacy.
• There is an increasing global trend towards PharmD degree education
• The list of countries that transitioned from the BPharm to the PharmD degree, are as
follows, U.S., Canada, Hungary, Italy, Japan, South Korea, Pakistan, Saudi Arabia, Thailand,
Benin, Cameroon, Republic of Congo, Senegal, Tunisia, Nigeria and Gana.
• It would appear that pharmacy schools across Asia and within the Middle East are promoting clinical
pharmacy. These countries are re-adjusting their degree programs by introducing Pharm D degrees as
entry level qualifications into pharmacy.

Dr. Dima Saeed

Dr. Dima Saeed
 • In Jordan, pharmacy practice generally involves
inventory management and the preparation and
Pharmacy practice in dispensing of medicines.
Jordan • Pharmacy practice is governed by the JPA’s Drug
and Pharmacy Law 2001 and the Ministry of
Health’s Public Health Act 2008 and Narcotic
Drugs and Psychotropic Substances Law 1988.
• The Ministry of Health is responsible for the
registration of pharmacy premises, whereas the
JFDA regulates the registration of medicines and
medical devices.
• Pharmacists do not have any prescribing
privileges.

Dr. Dima Saeed

 Pharmacy practice in Jordan
• Employment opportunities for pharmacists in Jordan are similar to those
in other countries in the Middle East and worldwide. Most pharmacists
work in community pharmacies, followed by pharmaceutical companies
and hospitals.
• The private sector is the main employer of health workers in Jordan.
• About 91% of pharmacists work in private community pharmacies,
private hospitals, pharmaceutical companies, and cosmetics and
medical supplies companies.
• Public sector pharmacists work in the Ministry of Health, university
hospitals, Royal Medical Services, and not-for-profit organizations
such as the UNRWA.
Dr. Dima Saeed
 Pharmacy practice in Jordan
• Community pharmacies, either pharmacist-owned or within pharmacy
chains, are the most common pharmaceutical facilities in Jordan, and there
are about 2500 pharmacies across the country
• Community pharmacies provide a wide range of prescription and
nonprescription medicines, as well as cosmetics, skin care products, and
medical equipment.
• Pharmacies are highly accessible, and many patients therefore seek medical
advice from pharmacists before visiting a physician.
• Unfortunately, patient-centred pharmaceutical care is rarely provided, and
the duties of most community pharmacists remain focused on medication
dispensing and inventory control.
• Patient counselling and education are seldom performed effectively, and
very few pharmacies keep any patient records.
Dr. Dima Saeed
 Pharmacy practice in Jordan
➢Hospital pharmacy practice:
▪ Hospital pharmacies can be divided into inpatient and outpatient
pharmacies.
• The general responsibilities of hospital pharmacists include:
a) drug procurement and inventory management,
b) order processing,
c) medication distribution,
d) drug information,
e) participation in patient safety and quality improvement initiatives
f) ensuring the availability of medications with affordable prices.
Dr. Dima Saeed
 Pharmacy practice in Jordan
➢Pharmacists in Jordan also work in:
• Regulatory bodies such as the JFDA,
• Universities (as academics and researchers),
• Research institutions,
• Drug information centres, including the Jordan Drug Information and
Toxicology Center at the Royal Medical Services, the Drug Information
Center at the King Abdullah University Hospital, and the Jordan National
Drug and Poison Information Centre at Jordan University Hospital.
• Drug information centers (DICs) provide online services 24 h a day, helping
people know more about the appropriate use of medications.

Dr. Dima Saeed

 Pharmacy practice in Jordan
➢ The role of the pharmacist in both public and private primary care clinics is
limited.
▪ Some of the multiclinic centres have their own pharmacies, which generally
keep limited quantities of essential medicines and are run by pharmacists
or pharmacy technicians.
▪ The role of the pharmacist in such pharmacies is mostly restricted to
dispensing medications and inventory management.

Dr. Dima Saeed

Dr. Dima Saeed